32 One year mortality from selected cancers: a dubious success of screening, russia

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Abstract

Background

Early diagnosis is a preferred action to reduce the cancer mortality – second leading cause of death in Russia. Since 2006 the programs of the screening for different cancers were introduced. Since 2015 the reduction of the one year mortality (1YM) is reported as a major success. Objective of this study is to analyze the size of the effect and potential side effects.

Methods

We analyzed national cancer statistics for years 2007–2016, calculating the additional cases found, mortality and the change of the 1YM in cancers stage III–IV.

Results

Four selected cancers were reported as a success story of screening with reduction of 1YM by 21%–49% during 10 years. The size of the 1YM reduction is influenced by the increased detection of cancer stages I–II. Recalculated to the number of cancers stage III-IV the 1YM reduction is 2–3 times lower. The side effect of the inflated 1YM reduction is the increase of the early stage cancers by 37%–137%.

Results

In the population the mortality from breast cancer decreased 14%, for prostate cancer increased 15% and not changed significantly for cervix and colon cancers.

Discussion and conclusion

The screening for four prevalent cancers led to the increased incidence mostly due to early I–II stage cancers. During 10 years the number late stage cancers did not reduced. Reduction of the 1YM significantly depends from the inflated denominator – the cases found. In Russia the cancer care is in short supply. By the expert opinions 2/3 of needed does not have access to adequate chemotherapy and ¾ to the radiotherapy. Expansion of the screening does not led to the reduction of the incidence of the late stage cases but exaggerate the demand for the scarce treatment.

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